Nysom K, Mølgaard C, Holm K, Hertz H, Michaelsen K F
Paediatric Haematology and Oncology Section, Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark.
Int J Cancer Suppl. 1998;11:40-3.
Our aim was to review current information on body composition and bone mass after cessation of therapy for childhood cancer and to present preliminary data on body composition and bone mass in a group of Danish survivors of childhood leukaemia or lymphoma. Elevated body-mass index (weight/height2; BMI) is frequent after treatment for childhood acute lymphoblastic leukaemia. BMI increases during therapy or within the first year after therapy and remains abnormal thereafter. Treatment with corticosteroids, abnormal growth-hormone secretion after treatment with cranial irradiation (CI) or corticosteroids, younger age at diagnosis, or female gender were risk factors for elevated BMI in earlier studies. We evaluated 185 survivors of childhood leukaemia or lymphoma by dual-energy X-ray absorptiometry scanning. We found elevated whole-body relative fat mass, which was associated with CI. Other studies found reduced bone mass in the radius, the lumbar spine and the whole body after treatment for childhood cancer. Growth-hormone deficiency that is not adequately corrected, CI, reduced height or reduced weight were risk factors for reduced bone mass. In our 185 participants, the whole-body bone mass was also reduced significantly compared with reference values. CI and older age at follow-up were risk factors for reduced bone mass. We conclude that the elevated relative fat mass and reduced bone mass seen after treatment for childhood leukaemia or lymphoma is associated mainly with CI.
我们的目的是回顾关于儿童癌症治疗停止后身体成分和骨量的现有信息，并展示一组丹麦儿童白血病或淋巴瘤幸存者的身体成分和骨量的初步数据。儿童急性淋巴细胞白血病治疗后，体重指数（体重/身高²；BMI）升高很常见。BMI在治疗期间或治疗后的第一年内增加，此后一直异常。在早期研究中，使用皮质类固醇治疗、颅脑照射（CI）或皮质类固醇治疗后生长激素分泌异常、诊断时年龄较小或女性性别是BMI升高的危险因素。我们通过双能X线吸收测定扫描评估了185名儿童白血病或淋巴瘤幸存者。我们发现全身相对脂肪量升高，这与CI有关。其他研究发现，儿童癌症治疗后，桡骨、腰椎和全身的骨量减少。生长激素缺乏未得到充分纠正、CI、身高降低或体重减轻是骨量减少的危险因素。在我们的185名参与者中，全身骨量与参考值相比也显著降低。CI和随访时年龄较大是骨量减少的危险因素。我们得出结论，儿童白血病或淋巴瘤治疗后出现的相对脂肪量升高和骨量减少主要与CI有关。
